TN DPH suggests sensitive approach to encourage cervical cancer screening

CHENNAI: Despite the Union and State governments’ various measures to encourage early screening to detect cervical cancers, factors like lack of awareness on the subject, distrust in the medical process, fear of pain during procedures, and fear of possible cancer diagnosis deter women from taking on the screening.

The Directorate of Public Health and Preventive Medicine, in a recent narrative review of research studies on cervical cancer, noted that comprehensive efforts are necessary to improve access to cervical cancer screening and reduce the morbidity and mortality associated with this preventable disease.

The DPH review classified four types of barriers faced by Indian women in accessing the screening as awareness-based, anxiety-based, societal and economic barriers.

It said the reasons for not taking up cancer screening were women feeling they are not at risk for cancer, not being aware of symptoms or economic and societal reasons like lack of pay and family support, and stigma attached to cancer, particularly in rural areas. The stigma mostly stems from associating cervical cancer with sexually transmitted diseases. Many women prioritize daily income over preventive healthcare and fear losing income due to time off work. It is coupled with the inability to afford treatment if diagnosed, further discouraging going through with the screening.

The review suggests that a multi-pronged approach is required to address these barriers. Culturally sensitive interventions and engaging family members in preventive healthcare are significant in tackling social stigma. Training healthcare providers to address fears and build trust is also crucial.

"Shifting to HPV-based screening from Visual Inspection with Acetic acid (VIA) can overcome many barriers as it is painless, encouraging participation, and self-sampling enhances compliance. HPV testing offers greater sensitivity and specificity, enabling accurate risk assessment and motivating regular screenings, as recommended by the World Health Organization," the review stated.